Predictors of asthma in young children: Does reporting source affect our conclusions?

Both the size and statistical significance of sociodemographic and early he alth risk factors on childhood asthma vary across studies, in part because some studies rely on parents' retrospective reports of health conditions wh ile others are based on medical records. The authors compare predictors of asthma alternately using maternal reports and medical records for the same set of children. Data are from the 1988 National Maternal and Infant Health Survey and 1991 Longitudinal Follow-up, which collected information from b irth certificates, medical records, and mothers of a nationally representat ive, population-based cohort, allowing comparison across data sources for a consistent sample of young children in the United States. Concordance betw een maternal reports and medical records on asthma is moderate (kappa = 0.4 8). The authors find considerable discrepancies in both the estimated preva lence of asthma and the distribution across children with different sociode mographic and health characteristics, depending on the source of asthma dat a. Black race, male gender, and preterm birth are found to be risk factors for asthma regardless of data source. Poverty, large family size, urban res idence, maternal smoking, and breastfeeding are significantly associated wi th asthma based on maternal reports but not medical records. Lower health c are utilization among poor, uninsured, and urban children may account for p art of the discrepancy.